Enhancing Motivation and Adherence to Exercise Rehabilitation in Stroke Survivors

本项目旨在建立将当代运动动机原则纳入中风幸存者康复计划的可行性。医学和外科手术的进步提高了中风患者的存活率，但这一进步也意味着支持患者康复的康复服务面临越来越大的压力。为了使患者从康复计划中充分受益，他们必须坚持他们的规定计划。坚持治疗会显著影响患者的预后。然而，对中风患者来说，坚持体育锻炼康复尤其具有挑战性，特别是当他们从有监督的康复过渡到独立的康复时。卫生专业人员意识到在中风康复过程中激励患者的必要性，但在有效的激励策略或如何实施这些策略方面的指导有限。当代人类动机模型整合了认知和情感动机过程，以帮助理解为什么人们坚持或脱离行为。应用这些当代动机概念可能会加强对康复方案的坚持。因此，该项目旨在将当前的康复交付与当代对动机的理解联系起来，以促进依从性。该项目将根据选定的激励原则制定和评估干预措施的可行性，这些原则可转化为患者、护理人员和/或临床医生的策略。本研究将发展对物理康复的动机和坚持的理解，以减轻与不良坚持相关的个人，社会和经济成本。这将进一步为临床医生和患者实施激励策略并测试其有效性提供依据。最后，参与该项目的患者和临床医生将能够指导未来关于动机原则在卒中康复和辅助理论发展中的适用性的研究。这项研究有可能为康复工作人员提供培训和教育机会。

This project aims to establish the feasibility of integrating contemporary exercise motivation principles into rehabilitation programmes for stroke survivors. Advances in medicine and surgery have led to improved chances of surviving stroke, but this progress means increasing pressure on rehabilitation services to support recovery of patients. For patients to fully benefit from rehabilitation programmes, they must adhere to their prescribed programme. Adhering to treatment significantly influences patient outcomes. However, adherence to physical exercise rehabilitation has been shown to be especially challenging in patients with a stroke, notably when they move from supervised to independent rehabilitation. Health professionals are aware of the need to motivate patients during their stroke rehabilitation, yet there is limited guidance on effective motivation strategies or how to implement them. Contemporary models of human motivation integrate both cognitive and affective motivational processes to help understand why people persist or disengage from behaviour. Applying these contemporary concepts of motivation could potentially enhance adherence to rehabilitation programmes. This project therefore aims to connect current rehabilitation delivery and contemporary understanding of motivation to facilitate adherence. The project will develop and assess the feasibility of an intervention, based on selected motivational principles, that can be translated into strategies for patients, carers, and/or clinicians. This research will develop an understanding of motivation and adherence to physical rehabilitation to alleviate the individual, societal and financial costs associated with poor adherence. It will further provide the basis for clinicians and patients to implement motivational strategies and test their effectiveness. Finally, the patients and clinicians involved in the project will be able to guide future research on the applicability of motivational principles in the context of stroke rehabilitation and aid theoretical development. The research has the potential to stimulate training and education opportunities for rehabilitation staff.